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Mesothelioma

Stages of Malignant  Mesothelioma

After malignant mesothelioma has been diagnosed, tests are  done to find out if cancer cells have spread to other parts  of the body.

There are three ways that cancer spreads in the body.

The stages of malignant mesothelioma are divided into two  groups.

Localized malignant mesothelioma (stage I)

Advanced malignant mesothelioma (stage II, stage III, and  stage IV)

After malignant mesothelioma has been diagnosed, tests are  done to find out if cancer cells have spread to other parts  of the body.

The process used to find out if cancer has spread outside  the pleura or peritoneum is called staging. The information  gathered from the staging process determines the stage of  the disease. It is important to know the spread of the cancer  in order to plan treatment. The following tests and procedures may be used in the staging process:

Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of the chest and abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the chest or abdomen. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Endoscopic ultrasound (EUS): A procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography. EUS may be used to guide fine-needle aspiration (FNA) biopsy of the lung, lymph nodes, or other areas. Endoscopic ultrasound-guided fine-needle aspiration biopsy.

An endoscope that has an ultrasound probe and a biopsy needle is inserted through the mouth and into the esophagus. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the lymph nodes near the esophagus. The sonogram helps the doctor see where to place the biopsy needle to remove tissue from the lymph nodes. This tissue is checked under a microscope for signs of cancer.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

    1. Through tissue. Cancer invades the surrounding normal tissue.
    2. Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
    3. Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (meta static) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is meta static breast cancer, not bone cancer.

The stages of malignant mesothelioma are divided into two groups.

Malignant mesothelioma stages are grouped into localized and advanced.

Localized malignant mesothelioma (stage I)

In localized malignant mesothelioma, cancer is found in the lining of the chest wall and may also be found in the lining of the lung, the lining of the diaphragm, or the lining of the sac that covers the heart on the same side of the chest.

Advanced malignant mesothelioma (stage II, stage III, and  stage IV)

Advanced malignant mesothelioma includes stage II, stage III, and stage IV.

In stage II, cancer is found in the lining of the chest wall and the lymph nodes on the same side of the chest. Cancer may also be found in the lining of the lung, the lining of the diaphragm, or the lining of the sac that covers the heart on the same side of the chest.

In stage III, cancer has spread to any of the following areas:

    • The chest wall.
    • The mediastinum.
    • The heart.
    • Beyond the diaphragm.
    • The peritoneum.

Cancer may have also spread to lymph nodes on the other side of the chest or outside the chest.

In stage IV, cancer has spread to distant organs or tissues.

Reprinted with Permission of The National Cancer Institute©.